OASIS Alert

When it comes to preventing problems with your high-therapy claims, making certain everyone is on the same page is vital. Be sure you’re all working efficiently in the following areas, says Julianne Haydel of Haydel Consulting Services in Baton Rouge, La.

Case conferences: The therapist must attend case conferences and report updates as required by the patient’s condition, Haydel says. It’s not always possible to attend in person but therapists can call in or send a written report prior to the case conference with information regarding how they can be contacted for questions.

Additional visits: Case managers or team leaders must be aware that they shouldn’t sign off on additional orders without talking to the therapist. A new therapist working for a contract therapy company may think the patient could really benefit from a few more visits. In discussing this with the therapist, the nurse may determine that the patient is approaching the ethical line of homebound status.

Medication: Nurses need to make certain therapists know about any new medications, wounds, or lab results that might impair the patient’s ability to participate in therapy. It’s better to put off a visit than to go spend 15 minutes with a patient in pain who receives no benefit from the visit, Haydel says.

And therapists need to reciprocate by being alert to medication changes, Haydel says. Therapists may not be comfortable with medications but they can ask the patient each visit if there have been any med changes. They can read a prescription bottle and report to the nurse, she says.

Payment: Therapists need to understand payment ramifications. “Of course, telling a therapist that 20 or more visits can trigger an ADR results in a lot of episodes with 19 visits,” Haydel says. So it’s important to continue to make certain the services your agency provides are appropriate.

“We like to blame therapists,” Haydel says. “The fact is that the agency is responsible for knowing what is going on with their patients.”